[Clinical analysis and treatment of carcinoma of the prostate with bone metastasis]

We carried out a clinical analysis of carcinoma of the prostate with bone metastasis in 141 cases of prostatic cancer treated between 1965 and 1984. Among these, there were 64 cases of stage D, 45.4% and 55 cases of bone metastasis at the first visit. Stage D cases were mainly treated with estrogen. Poorly differentiated adenocarcinoma was observed in 62% of the stage D cases. Elevated pretreatment levels of serum acid phosphatase in the cases of bone metastasis were found in 47.8-71.4% of patients with poorly differentiated adenocarcinoma. Elevated acid phosphatase levels were also normalized by estrogen administration in over 60% of cases, regardless of the degree of differentiation. Also, clinical efficacy of estrogen was observed in more than 80% of stage D cases with any degree of differentiation. The most frequent clinically observed metastatic site was bone. Pain-relieving effects of estrogen, radiation and ifosfamide were observed in 76.3%, 92.3% and 70%, of patients, respectively. The cause of death in stage D patients was mainly aggravation of metastatic lesions. The period for which estrogen was effective was 45 months on average in cases who died at stage D. The period from reactivation to death averaged 16 months, while the period from the beginning of treatment to death in cases unresponsive to estrogen was only 11 months on average.